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Toothache...Now What?

Many of us have had sleepless nights because of a dreaded toothache.  The lucky ones may of had an inkling of warning, but most are totally caught off guard by this dental emergency.  As a practicing dentist in Naples, Florida, there are three common causes of toothaches that we treat.

The most common toothache we treat is the dreaded dental abscess.  An abscess is an infection of the inside of the tooth, which quickly spreads into the jaw bone causing pressure and pain.  This can be caused by deep dental decay, a fractured tooth, or even excessive tooth grinding.  There is little a patient can do on their own to treat the abscess.  A trip to the dentist for definitive diagnosis and treatment is necessary.  Antibiotics may be prescribed, and a treatment plan to remove the infection would be discussed.

A second common toothache we see actually involves infection of the surrounding gum tissue.  Periodontal disease, poor oral hygiene, thick buildup of plaque, and even food particles can get lodged in the gums, causing an inflammatory response and infection.  Again, a trip to the dentist for proper diagnosis is necessary.  An x-ray may be taken to verify the etiology.  In cases of gingival abscesses, a thorough cleaning out of the area usually is all that is necessary.  Often times, antibiotics may also be prescribed.

Lastly, a very common cause of a toothache involves a fractured tooth.  If a tooth fractures beyond the thickness of enamel, the second layer of tooth becomes exposed, and can be sensitive.  Sometimes the fracture extends all the way into the nerve of the tooth, which is usually accompanied by extreme discomfort.  A dentist will be able to evaluate the extent of the fracture, and treat accordingly.

The take home message is...don't wait for it to go away on its own.  Toothaches usually require dental intervention.  The earlier the intervention, usually it means less discomfort, less treatment, and less headaches.




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The New Crown in Town

Since it's advanced over three years ago, zirconium crowns have demonstrated clinical service superior to any other tooth colored crown currently available. Zirconium is a natural material that can be found on the periodic table of elements. Because of its characteristics, it actually is found amongst the metals. It has become the "go to" crown choice due to its very high flexural strength, it's adequate aesthetics, and allows for minimal preparation of the teeth when spacing is at a minimum. It allows the dentist to prepare teeth as if a gold crown were to be placed, but the final result is a white tooth. The material has been found to be kind to the opposing teeth, and its surface texture mimics that of enamel quite impressively.

We currently use these crowns  on both natural teeth,  and on implants. Many patients exhibit bruxism,  or tooth grinding on a daily basis, and require a strong alternative to previous dental crowns.  When compared to other white crown available, zirconium crowns by far exceed  the others and strength by over three times. This translates into more predictable dentistry,  longer crown life,  and improved aesthetics.

As a dentist in Naples Florida,  patients have come to expect  white crowns  when faced with restoring a tooth. With  zirconium  crowns, I can offer esthetic crowns to patients who have been told in the past that they were not candidates. Due to the success of this material, I would not be surprised  if metal-based  dentistry  will be a thing of the past.

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Protect yourself from Oral Cancer 

Although not as prevalent as other forms of cancer such as lung, breast, and colon cancer, oral cancer still lurks its ugly face in America and worldwide.  According  to the Oral Cancer Society Foundation, approximately 44,000 Americans will be diagnosed this year with oral cancer, and 8000 deaths will be contributed to it.  These numbers are significant enough that it deserves serious preventive measures.

Traditionally, tobacco and alcohol use has been the major causative agent of oral cancer.  However, more recently, the increased incidence of oral cancer is being largely blamed on the Human Papilloma Virus 16, or HPV16 for short.  This is the same virus responsible for over 90% of all cervical cancers. 

Oral cancers are so dangerous because they often are undetectable in the initial stages, which allows for secondary spread to other body parts.  They tend not to hurt, and no physical color changes may be apparent.  It is estimated that over 20% of oral cancers have a high chance of developing into a secondary cancer elsewhere.  Most oral cancers are seen in patients over the age of 40, with it affecting males 2:1 over women, and black Americans twice as much as white Americans. 

The question to ask is," How can we prevent this?"  Besides being diligent to inspect your own body of any changes in the appearance or comfort, the best line of defense lies at the dental office.  Dentists and hygienists are specifically trained to look for the signs and symptoms of oral cancer.  As a Naples dentist, I have personally diagnosed several oral lesions that required further treatment.  I regularly perform oral cancer screenings at the office, and all new patients are required to have one.  We look for the warning signs, such as: a white or red patch which may or may not be ulcerated, which doesn't heal in 2 weeks, a lump or mass, pain upon swallowing, or a hoarseness in the voice.

The best treatment for oral cancer is to avoid it, and early detection is vital to survival.  If you, or a loved one is concerned with the possibility of oral cancer, please schedule a comprehensive dental evaluation just to be safe. 

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Prevent Bone Loss After Tooth Loss

Most people dread seeing the dentist on a good day, let alone on an emergency basis.  Unfortunately, it is common for patients to develop infections, or fractures around the teeth which requires us to extract a tooth.  Traditionally, the tooth would be removed, and the patient left biting on a gauze pack.  This technique was effective, but the resulting bone loss can create future dilemmas down the road.  Fortunately today, we can help prevent bone loss following extractions.

Routinely, when we extract a tooth in our office, the patient is offered Socket Preservation.  This is a fancy term for bone grafting.  When a tooth is lost, we can expect 40-60% of the surrounding bone to atrophy within the first 2 years, and 1-2% each year thereafter.  The bone grafting procedure helps to eliminate the significant initial bone loss, "preserving" the integrity of the extraction site.  This becomes important when it comes time to restore the site with a dental implant, bridge, or denture.

When a dental implant is planned, the area must have not only enough bone height and width to hold it, it must be quality dense bone.  Bone grafting helps maximize those three features.  Even if a dental implant is not planned, maintaining the bone below a bridge of denture is paramount to help support the dental prosthesis, and to achieve maximum esthetics.

As a practicing dentist in Naples Florida for the past 15 years, I have performed this valuable service routinely.  I truly believe in its benefits, and allows patients to make healthier, and more predictable choices for their mouths.

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CT Scans Improve Dental Implant Surgery

When a loved one is contemplating a dental implant, I highly recommend a CT scan be performed, preferably in the  office on a dental CT scanner, prior to any implant surgery.

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Dental Implants:  The Best Choice

Over the past 10 years, the popularity of Dental Implants has absolutely taken off.  There are many reasons for this, however, I believe the main reason lies in their versatility and predictability.

Dental implants are titanium tooth replacements which are placed into the jaw.  They are very similar in shape and size to the actual tooth roots they replace.  The procedure to place them is surprisingly comfortable, with the use of only local anesthesia, and very often the whole procedure takes about as long as a typical filling.  The advent of  Dental CAT scanners has taken much of the guesswork out of the procedure, allowing the dentist to plan the surgery virtually beforehand.  This translates into a much safer, faster, and more accurate outcome.  There are 3 major uses for dental implants in todays' world. 

Obviously, Dental Implants can be used to replace one or multiple teeth.  Either these teeth were lost previously, or perhaps they currently need to.  Implants can be placed into those sites, even sites where the tooth was just removed. 

Typically, Dental Implants are used to anchor either crowns or bridges securely into the moth.  They mimic the natural architecture of the dentition, they are color matched to be in harmony with the other teeth, but most importantly, they are the strongest tooth replacement option available.  They are not subject to decay, root canals, or periodontal disease.  Patients choose this option over others also because the teeth are secured to the implants permanently, and they don't come out.

Dental Implants also can be used to anchor a fixed hybrid dental appliance.  I know that that's a big word, but its pretty easy to visualize.  A fixed hybrid appliance is like a denture, except instead of removing the appliance after meals or at night, the appliance is "fixed" or attached to the implants with special screws that only a dentist could remove.  This option is often chosen when a patient is missing most or all of the teeth in an arch.  It offers the patient the confidence that the teeth will not slide around of flop out while eating and speaking.  And because it's fixed with screws, and not cement, it can be removed, if necessary, without damaging  it.  Typically, these appliances have been fabricated out of plastic, like a denture, but recently,  porcelain hybrids are available which offer greater strength, wear resistance, and increased aesthetics.

Lastly, Dental Implants are commonly used to secure complete and partial dentures in place.  Unlike the hybrid appliance, these implant dentures can be removed by the patient daily.  This allows the patients to very effectively clean not only the denture, but also the implants.  Special attachments, similar to "o" rings are placed into the denture, and these rings grab the top of the implants, and snap in.  This option is very popular because it requires only a limited number of implants to be placed, and allows patients to have the confidence of chewing and speaking without the teeth slipping.  This is a great service we offer for those suffering with loose fitting dentures.  Most patients who receive this treatment wish they would have done it years ago. 

As you can see, Dental Implants are more than just a single tooth replacement solution.  Today, Implants are used to restore complete sets of teeth and everything in between.  I encourage you to contact my office for more information on Dental Implants, and how they might help you.  I'm a Naples Florida Dentist, and my door is always open for new patients and second opinions.

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